Ireland is “not too far off a major catastrophe in general practice” due to the shortage of GPs in the speciality, a doctor has warned.
Recent figures from the Irish College of General Practitioners (ICGP) estimate that of the approximately 4,700 GPs currently working in the State, 700 will retire over the next five years, while just 350 GP training places are planned for 2026.
Dr Knut Moe, the director of the ICGP’s Network of Establishing GPs Programme, says the issues in general practice are taking their toll on doctors: “We have so many plates in the air - we are on tenterhooks trying to keep everything going and trying to provide a quality service and timely access to those services.”
While the shortage of GPs in the country has been an ongoing issue for a number of years, the strain of Covid has added to the burden of general practices, and the healthcare system at large.
“The worry is if things continue then people will get burnt out and they will say ‘you know what, I’ve had enough’. That’s what we don’t want to see, we don’t want to lose GPs to other countries.”
Training
The issue, Dr Moe believes, is a lack of training and recruitment. Despite strides being made to offer more places for the training of GPs, he says the numbers coming in are “not even enough to fill the potential shortfall that’s coming”.
He stresses there is demand for people wishing to enter general practice, so training capacity must be expanded in response.
Ireland has also long benefitted from doctors coming from abroad to work, Dr Moe says: “We have relied for years and years on internationally trained doctors and graduates, and they have really propped up areas of our health service and gone to areas where maybe others weren’t so keen.
“Covid has had a massive impact because there’s a lot less migrancy of doctors coming [to Ireland], which would have papered over the cracks a bit.”
Attracting these “fully and appropriately qualified” doctors from overseas would ease the pressure, but Dr Moe stresses that a rethink is needed to tackle the issues causing doctors to leave Ireland. He believes Irish doctors go to countries such as Australia “not necessarily for better money, but for better working conditions and a better work-life balance”.
While the shortage of GPs is being felt throughout the country, Dr Moe also says that some rural areas have been particularly hard-hit, as fewer doctors may be willing to work in isolated settings. He suggests taking a leaf out of Canada or Australia’s book, “places where they are used to drawing people into isolated areas”, where they incentivise doctors to work in places of short supply.
Despite the stark figures, Dr Moe insists general practice is “one of the most efficient arms of the health service” and has adapted well throughout Covid.
“Covid has been great in so far as it has shown an appetite for change and there has been a lot of innovation in a short space of time and it shows that innovation can be really transformative,” he says.
Winter
However, facing into a second winter with Covid, Dr Moe warns it is important “not to play pass the parcel with blame in the healthcare system” as “everybody is working hard and everyone is under a lot of pressure”.
Due to Covid, he says people, and in particular parents, can no longer trust their instincts regarding respiratory ailments, causing them to seek appointments with their GP when they previously would have waited for the symptoms to ease naturally.
Dr Moe explains his practice in Churchtown, Dublin, recently had its busiest week in the past 18 months due to the level of respiratory illnesses going around, on top of the normal, day-to-day appointments seen by GPs.
“I’ve had more face-to-face patients with respiratory illnesses in the past week than I did for all of last year,” he says.
Looking ahead, Dr Moe says general practice is “braced for a hard winter”, but adds: “We have to look at what the winter after that will be like, or the winter after that again, because I’m not sure how much we can solve in the next three to four months.”
“It’s really about what we can plan so we don’t bring the healthcare service to its knees, and that goes for GPs to hospitals, right through the system.”
